Since 1996, the U.S. Public Health Service has been urging
all healthcare workers to ask every one of their patients if
they smoke and to counsel smokers to quit, said senior author
Amy Ferketich, a professor at the Ohio State University College
of Public Health in Columbus.

But when she and her colleagues analyzed survey data from
2010, they found that less than 12 percent of smokers who
visited a dental worker and only half of smokers who saw a
doctor reported receiving guidance about how to break the habit.

"Dental students as well as medical students should get some
training as to how to address the smoking issue," she said.

"Provider advice to quit is quite powerful. In the end, the
healthcare system can save money because patients will quit,"
she said.

Counseling combined with nicotine-withdrawal pharmacology -
in the form of patches, gum and lozenges - works, Ferketich
said.

Since 1964, when the surgeon general first reported a link
between smoking and lung cancer, 8 million Americans have been
saved from premature smoking-related deaths, another 2014 study
found (see Reuters Health story of January 7, 2014 here: http://reut.rs/XET2nh).

Smoking nonetheless remains the leading cause of preventable
death in the United States, according to the CDC.

Pharmacist Lisa Kroon sees training as key to identifying
smokers and counseling them to quit. Kroon is a professor at the
University of California, San Francisco, School of Pharmacy and
was not involved in the current study.

"Until providers are trained, it's hard for them to take
action," she said. "To get smoking-cessation training
incorporated into training is not an overnight process."

Today, pharmacy students at her school get nine hours of
smoking-cessation training, Kroon said. When she was a pharmacy
student 20 years ago, she received just one hour.

Kroon believes pharmacists armed with nicotine-withdrawal
drugs can play a lead role in helping smokers quit.

"The wagging-the-finger approach is not effective," she
said. "We need to provide healthcare professionals with more
effective tools to help people stop."

Dental epidemiologist Dr. Benjamin Chaffee told Reuters
Health he believes the main barriers to dentists and hygienists
counseling patients to stop smoking are a lack of time, a lack
of training and a lack of confidence in their ability to have an
impact.

Chaffee is a professor in the University of California, San
Francisco, School of Dentistry and was not involved in the
current study.

"The majority of dentists will tell you they think it's an
important part of their role, but a lower percentage will tell
you they feel confident they know what to say and how to say
it," Chaffee said.

"There's definitely room for improvements in the training
dentists get as dental students, and there's also room to
strengthen the training and other resources available to them
once they're already in practice," he said.

Each year, 7 out of 10 smokers visit a clinician, the U.S.
Public Health Service practice guidelines say. Smokers are more
likely to visit dental offices than doctors' offices, Chaffee
said.